Individual
MR. GLEN ALAN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
6611 W BELL RD, (INSIDE FRYS), GLENDALE, AZ 85308-3607
(623) 334-2953
Mailing address
3420 E CAROL ANN WAY, PHOENIX, AZ 85032-3820
(602) 769-2714
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP4205
AZ
Other
Enumeration date
10/17/2011
Last updated
09/26/2014
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